Provider Demographics
NPI:1093706178
Name:CHARDE, JOHN P (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:P
Last Name:CHARDE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:68 RESERVOIR RD
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06039-1011
Mailing Address - Country:US
Mailing Address - Phone:860-435-0110
Mailing Address - Fax:860-435-4835
Practice Address - Street 1:68 RESERVOIR RD
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:CT
Practice Address - Zip Code:06039-1011
Practice Address - Country:US
Practice Address - Phone:860-435-0110
Practice Address - Fax:860-435-4835
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT014589208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics